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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endoscopic retrograde cholangiopancreatography (ERCP) is essential in the diagnosis of pancreatic disease, jaundice and in post-cholecystectomy syndromes, as well as in cases where cholecystography and i.v. cholangiography fail to explain disturbances that strongly suggest bile duct involvement. Its confirmation of clinically established pancreatic disease is much more positive than that given by scintiscanning and multiple superselective arteriography. Unlike the latter, it also permits the differential diagnosis of chronic pancreatitis, cancer of the pancreas, pseudocysts, etc. and distinguishes medical and surgical pancreatitis (stenosis, proteinaceous calculi, and obstructing pseudocysts). Differential diagnosis of progressive jaundice on clinical grounds or with the aid of ordinary means of examination is sometimes unsatisfactory. ERCP clearly distinguishes medical and surgical forms, so that exploratory laparotomy is not needed in subjects with liver-cell forms. It also shows the nature, site and extent of extrahepatic obstruction, and points to the organic cause in 79% of cases of postcholecystectomy syndrome. Right hypochondrial pain or intermittent jaundice and negative cholecystography and i.v. cholangiography is a further indication, since ERCP will reveal disease of the pancreas or bile ducts (cholelithiasis, choledocholithiasis, sclerosing cholangitis, etc). It is also useful in the diagnosis of cirrhosis, abscess, echinococcus cyst and primary or secondary cancer in cases where needle biopsy and-or arteriography are either contra-indicated or inconclusive.
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PMID:[Diagnostic value of retrograde cholangiopancreatography by transendoscopic route]. 66 74

Involvement of the spleen or its vasculature in inflammatory disease of the pancreas may result in life-threatening hemorrhage. Retrospective analysis of six patients having direct splenic involvement and/or occlusion of the splenic vein secondary to pancreatitis or pseudocyst showed that removal of the spleen as a portion of an appropriately timed operation for complications of pancreatitis uniformly resulted in an uncomplicated course and survival (3 patients). Leaving the spleen in place when it was directly involved in a pseudocyst and/or when the splenic vein was occluded resulted in postoperative bleeding, the requirement for reoperation, and death from septic sequelae (2 patients). One patient died of progressive respiratory and renal failure because initial operation was inappropriately delayed. We recommend splenectomy as a portion of an appropriately timed operation for complications of pancreatitis when the splenic vessels are involved and/or when the spleen is directly involved in a pseudocyst or lesser sac collection.
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PMID:Splenectomy: its place in operations for inflammatory disease of the pancreas. 92 Aug 79

Alloxan diabetes was induced in inbred rats that then were divided into four groups consisting of unoperated diabetic controls, sham-operated diabetic controls, rats given pancreaticoduodenal isografts, and rats given duct-ligated pancreas isografts. The animals were studied for from 18 months (controls) to two years (transplants) and the following important results were obtained: 1) In striking contrast to the diabetic controls, pancreas transplants of both types produced immediate and permanent relief of hyperglycemia, immediate and lasting elevation of serum insulin levels, a normal weight and growth curve, and good health for two years. Removal of the graft was followed by recurrence of severe diabetes. 2) Pancreas transplants of both types prevented the widespread and severe renal, ophthalmic and neural lesions of diabetes that were found in the diabetic controls. 3) The duct-ligated pancreas graft and pancreaticoduodenal transplant were equally effective in controlling diabetes. Ligation of the pancreatic duct was not followed by significant morphologic or clinical evidence of pancreatitis or by loss of endocrine function. 4) Portal venous drainage of the pancreas transplant was unnecessary for good endocrine function.
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PMID:Long term studies of pancreas transplantation in experimental diabetes mellitus. 109 93

Pancreas scintiscanning using electronic image subtraction has proved useful in the diagnosis of pancreatic disease. Confirmation of this was found on comparison of the scintiscan picture and the surgical picture on gross inspection in 50 cases. Findings indicative of pancreatitis, cysts and tumours are illustrated, together with those given by scintiscanning of pancreas alterations occuring in the course of diseases affecting nearby organs.
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PMID:[Selective pancreatic scintiscanning in the diagnosis of pancreatic diseases]. 111 42

Pancreas of normal dogs and the inflamed gland of experimental pancreatitis were studied by intra-arterial injection of Microfil, a silicone-rubber compound especially suited for study of the microcirculation. Duodenal vasculature and lobular vessels of the pancreas were studied as were those supplying the duct. Inter-lobular vessels were well visualized in the normal pancreas and intralobular vessels formed a fine reticular pattern throughout the cleared lobules. A complex network of vessels in the pancreatic duct was observed using this technique, apparently derived from the interlobular vessels. The blood supply of each layer of the duodenum was evaluated. Intraductal trypsin injection produced focal areas of pancreatitis associated with edema, poor vascular filling and spastic changes of the lobular vessels. Extravasation of Microfil, although not apparent on normal specimens, was prominent in inflamed specimens and suggested vascular weakness and disruption. Pancreatic lobules adjacent to inflammatory areas showed definite evidence of dilatation. The inflamed pancreatic ducts were markedly edematous, thickned, and showed incomplete vascular filling. When the duodenum adjacent to pancreatitis was injected with Microfil, edema and vasoconstriction were especially prominent in the duodenal muscular layer.
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PMID:Microcirculation of the normal and inflamed canine pancreas. 113 Aug 66

The clinical features of patients with macroamylasemia are diverse. A certain correlation between macroamylasemia and the disease of the pancreas or hepato-biliary system may exist, because among 7 patients in this series 4 patients were diagnosed as acute pancreatitis or relapsing pancreatitis and another patient was performed choledochotomy and manipulation of papilla of Vater may had a effect on pancreas. Among other 2 patients, one was completely symptomless and had no abnormal findings and in another the action of anticancer drugs is suspected. The course of macroamylasemia is usually chronic but in this series one patient had acute transient macroamylasemia and another one had intermittent macroamylasemia during exacerbations of pancreatitis. The serum amylase levels are mostly 2-4 times above normal with one exception (192 Somogyi units) and urinary amylase values are low with one exception (1922 Somogyi units) during exacerbation of pancreatitis. Characteristic zymogram of macroamylase on electrophoresis is also reported.
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PMID:Macroamylasemia: clinical and laboratory features in 7 patients. 123 2

To clarify the relationship between the diminution of the serum protease inhibitor capacity and the severity of pancreatitis, the binding capacity of serum protease inhibitors for exogenous elastase 1 (E1) was investigated by gel filtration, the elastase activity of the alpha 2-macroglobulin (alpha 2-M)-elastase complex was measured, and the relationship between these findings and the severity of pancreatitis was studied in 13 patients with pancreatic disease and 6 healthy subjects. When 125I-labeled E1 was added to the sera of healthy subjects, it bound to alpha 2-M and alpha 1-protease inhibitor (alpha 1-PI) with a mean ratio of 72:28. In mild acute pancreatitis (n = 5), the binding capacity of alpha 2-M was less than that in healthy subjects. In severe pancreatitis (n = 4), most of the exogenous E1 bound to alpha 1-PI (alpha 2-M vs. alpha 1-PI, 13:87). This diminution in the binding capacity of alpha 2-M correlated well with the severity of acute pancreatitis. In the sera of patients (n = 4) with pancreatic cancer containing much immunoreactive E1, the proportion of exogenous E1 bound by alpha 2-M and alpha 1-PI (25:75) was similar to that seen in severe acute pancreatitis. A significant inverse relationship between the binding capacity of alpha 2-M and the activity of the endogenous elastase bound to alpha 2-M was seen in various pancreatic diseases.(ABSTRACT TRUNCATED AT 250 WORDS)
Pancreas 1992
PMID:Serum protease inhibitor capacity for elastase and the severity of pancreatitis. 128 Mar 65

Trypsinogen activation peptides (TAP) were quantified by radioimmunoassay in blood, urine, and peritoneal exudate of rats with experimental pancreatitis. Forty-four animals were studied, comprising a control group and four different induction techniques (cerulein, cerulein plus either 2- or 10-min intraductal glycodeoxycholic acid [GDOC] infusion, and cerulein plus intraductal GDOC with enterokinase [EK]). Significantly higher TAP concentrations were found at 6 h (or at death) in plasma and ascites of all pancreatitis groups compared with controls. TAP quantitation in hourly urine samples demonstrated significantly higher concentrations from the third hour onward in the most severe groups and from the fourth hour onward in the cerulein-treated rats. All nonsurviving rats had a plasma TAP of greater than 2.5 nM/L, whereas only 1 of 34 surviving animals had such a concentration (p less than 0.001). A significant stepwise increase in total TAP in ascites was found when comparing the cerulein group, the two GDOC groups, and the EK group (p less than 0.001). Chromatography of samples with a high TAP content demonstrated comigration with synthetic TAP. We conclude that free TAP are present in blood, urine, and peritoneal exudate of rats with experimental pancreatitis of different pathogenesis and that the amount of TAP may be indicative of the severity of the disease process.
Pancreas 1992
PMID:Generation and possible significance of trypsinogen activation peptides in experimental acute pancreatitis in the rat. 137 47

Pancreatic gene expression was analyzed in the rat during taurocholate-induced pancreatitis, with emphasis on the postacute phase where regeneration occurs. Increased expression of cellular oncogenes c-myc and H-ras followed a pattern typical of tissular regeneration. The c-myc protein was immunolocalized to acinar cells, in which amylase expression was concomitantly decreased. Such modifications in the program of gene expression and the presence of numerous mitotic figures confirmed participation of acinar cells in regeneration. There was, on the contrary, no evidence of duct cell proliferation and pancreatitis did not influence the expression of two mRNAs encoding ductal proteins. Expression of villin, which is a marker of the embryonic pancreas, increased by five times during pancreatic regeneration. The protein was localized to the tubular complexes, suggesting that cells forming those structures had returned to a protodifferentiated stage in which they should have recovered pluripotency. They might therefore supply the pancreas with any cell type needed to reconstitute functional parenchyma.
Pancreas 1992
PMID:Expression of genes associated with dedifferentiation and cell proliferation during pancreatic regeneration following acute pancreatitis. 144 58

Pancreas function, lipid peroxidation and antioxidant defence were studied in 154 children aged 1 to 14 years with food allergy. Allergic inflammation due to food allergy favours the origin of different abnormalities of pancreas function: functional (39.4%), reactive pancreatitis (31.3%), chronic pancreatitis (20.1%), and sclerosing chronic pancreatitis (9.2%). They occur in combination with lipid peroxidation activation and a decrease in antioxidant defence. The intensity of the latter ones is dependent on the variety of pancreas function disturbance. The most significant changes in lipid peroxidation and antioxidant defence were discovered in chronic pancreatitis.
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PMID:[Characteristics of the functional state of the pancreas, lipid peroxidation and antioxidant defense in food hypersensitivity in children]. 151 45


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